Left bundle branch pacing with optimization of cardiac resynchronization treatment: A case report

Figure 1 Preoperative basic electrocardiogram. The electrocardiogram results showed sinus rhythm, complete left bundle branch block, and QRS duration of 160 ms.

Figure 2 Electrode image. The left ventricular wire was successfully inserted into the left ventricular vein of the coronary sinus.

Figure 3 Electrode image. The wire was placed in the region of the left bundle branch, and the depth of the electrode could be seen.

Figure 4 Electrocardiogram. Unipolar pacing of the right ventricular septum and gradual rotation of the interior septum to reach the left bundle branch region (lead V1 R wave gradually increased, and the final QRS wave width was 137 ms). Comparison of the correction of complete left bundle branch block with unipolar pacing using ECG.

Figure 5 Electrocardiogram. A: Graph when the atrioventricular delay was adjusted to 130 ms, and the two-chamber pacemaker was fused with the right bundle branch and down transmission (QRS 110 ms); B: Left bundle branch pacing with the optimization of cardiac resynchronization.

Figure 6 Final electrode images (left anterior oblique position: 30 degrees; posterior and anterior sides).